International Individual Consultant for Implementation Research on Immunization Tracker at UNICEF Rwanda:Deadline: 24 Oct 2020

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Background

In many countries, birth registration rates are lower than the level reached by some health interventions. The reach of immunization programme highlights the potential for health systems to reach children in the first months of life. Health programs that track mothers, newborns and children have the means to initiate the process of the notification and registration of births and provide individual case identification (National identification number, NIN for Rwanda). This offers an opportunity for civil registration authorities to tap into the widely distributed health services to enhance birth notification and registration completeness. Furthermore, the health system can use its network of health workers to inform families and communities how to proceed with the process, where otherwise these children may have been missed and undocumented.
Digitalization of Health Management Information Systems (HMISs) is one of top priorities for Rwanda. Rwanda DHIS-2 is currently implemented in all 30 districts and 100% health facilities of Rwanda and is addressing critical barriers such as poor follow-up of individual cases, gaps in data availability/analysis, notification and regulation of births, immunized children and deaths; as well as in the community and at health facilities (hospitals & health centers).

Since September 2019, Rwanda has started to implement an Immunization Electronic Registry (IER) tracker for individual records within the DHIS2 platform. Within the next few weeks, the Ministry of Local Government will start to implement CRVS application which is now managed by local administration structures (Sector), when the CVRS application is implemented births and deaths registration will be automatically be done at health facilities.
This has been seen as an opportunity to concretize the integration of birth notification and registration into health program in Rwanda as a country with high coverage of immunization which is currently over 95% (Rwanda DHS 2014/2015). In order to advise the country on effective integration, Rwanda received a joint mission comprising UNICEF officers (HQ- IRDS unit; RO – Information, communication and technology in collaboration with Rwanda CO, health and child protection sections), HISP Rwanda and the University of Oslo in September 2019. The main objective of this mission was to explore the possibility to configure the DHIS2 – Birth module into immunization tracker and advise the country on an implementation roadmap.

The immunization tracker is currently implemented in all health facilities of Rwanda (health centers and district hospitals). Notification and registration are done at HFs and the plan is generate a nation identification number (NIN) for unique identification of every birth (yet to be implemented) to facilitate continuum of services for individual case. We will look for and add documentation on this.
The process to integrate birth notification into e-tracker will be done in two phases;

Phase One: Will be supported by partners (HISP, UiO and UNICEF). Birth and death notification information will be integrated into Rwanda immunization e-tracker. By collecting this information, the health care provider will check if the child has been registered into CRVS application and received the birth certification. to the Civil register at each health facility providers will review the birth notification and approve for certification into the CRVS platform, and an SMS system will be configured to inform the civil register.

Phase two: The Interoperability between CRVS and DHIS2 immunization Tracker. This phase will take long time as the country is working on the interoperability plan for all health and CRVS platforms.
In July 2020, Rwanda launched births and deaths notification and registration in health facilities (health centers and district hospitals) and for now all health facilities in Rwanda are implementing immunization tracker. In October 2020, the country is planning to start the implementation of e-tracker with configured birth notification/registration information. At initial phase of implementation of the integrated module, there may be implementation challenges that will need to be identified and addressed.

Justification

An implementation research on Rwanda Immunization tracker is planned to document lessons learnt and implementation challenges and explore potential solutions to inform effective implementation in future for sustainability. The present concept note aims to highlight process, general requirements and resource needed to undertake implementation research.

Objectives

The primary objective is to understand the process and status of implementation of the immunization tracker, linkage with CVRS, document implementation processes, changes and lessons.
The purpose of this assignment is to design, collect data, analyse data, make qualitative follow-up and write a report to address the objective defined above. The end product will be a final report and powerpoint presentation approved by Ministry of Health (MoH).

Work Assignment

This assignment will focus on the perspective of immunization tracker, immunization records and CVRS integration including birth and death notification and registration within health facilities and at community in Rwanda.
Processes, challenges, best practices/lessons and potential enablers for effective implementation of immunization tracker and CVRS will be identified.

The assignment should include a framework through which the immunization tracker captures information on CRVS, Birth/death notification and registration, integration of immunization with other key programmes (Nutrition, MNCH continuum of care) through immunization tracker, synergy between global and country standards and requirements, Strengthening monitoring and evaluation of immunization programme.

Methodology and specific tasks:

Methodology;
Methodology of the assignment will comprise desk review of data and reports on adolescent mental health, conducting high level meetings with government and partners health managers for strategic guidance and technical inputs; qualitative, quantitative and focus group discussions in target health facilities and communities to better understand the status of implementing immunization tracker better; and one-one-one consultative meetings with beneficiaries, providers and experts at health facilities (district, health centers and community).
The sample of communities/households is to be clearly described and the assignment should offer guidance on the sampling be representative and illustrative.

Specific tasks;
– To discuss and confirm the scope of the assignment with MoH and UNICEF. This particularly includes the purpose of the implementation research and the structure/content of the Outputs. with (i) program managers from ministries in charge of immunization program and CRVS program ( Ministry of Health and Ministry of Local governance) ; (ii) researchers from national institution(s); (iii) government partners involved in immunization and NIDA/CRVS, RITA/MoICT programs, (iii) UNICEF (HQ,RO and CO staff), (iv) representatives from UiO, HISP Rwanda and any other relevant organizations or institutions.
– Review relevant documents, other related health research and documents from Rwanda, and examples of similar assignments from other countries and tools used to inform the development of the design; as well as Rapid Situation analysis to collect information on program implementation and existing challenges to guide the research details and prioritization process
– Draft the inception report and agree with UNICEF and MOH before moving on. This will be reached from desk review of available qualitative and quantitative data from different reports, DHS and health management and information system (HMIS), consultations with, healthcare workers, health managers and target communities; and conducting key informants interviews with program managers, decision-makers, and researchers to identify priority research questions, themes and inform appropriate prioritization of the implementation research.
– Develop tools and protocols for desk review, assessments among
– Conduct qualitative assessment of immunization tracker and CRVS with healthcare workers, basic health facility staff and focus group discussions in target communities.
– Analyze the data and provide a draft report for initial feedback from UNICEF and MOH
– Share a revised draft report with UNICEF, MOH and partners, revise based on feedback, and validate the findings through a consultative forum with designed steering committee and TWGs to produce a final report that is approved by MOH

Deliverables
The Consultant will deliver four (4) deliverables associated with the assignment;

Deliverable 1: An Inception Report demonstrating the understanding of the assignment and including the methodology and plan to successfully complete the implementation research
Deliverable 2: Implementation research protocol and tools based on priority questions.
Deliverable 3: Draft report of the implementation research
Deliverable 4: Final report approved by appropriate forums within MOH, after validation and incorporating feedback

Description of outputs;

The consultancy will have the following outputs:

Output 1: The design overview can be a fairly short document presenting a snapshot (narratively and/or diagrammatically) of the IR including objectives, key research variables/questions, comments on methodology and proposed sample (options), timeline and points for decision/agreement before moving to other outputs. This may be revised through discussions with MoH, UNICEF and other partners. The design will need to be approved by the appropriate forums within MOH (Technical Working Groups/Steering Committee).

Output 2: Based on approved design, tools and protocols for quantitative and qualitative data collection and analysis need to be developed. The tools and protocols should translate all of the methods in the design into specific data collection and analysis instruments to be used as part of the assessment. These tools and protocols for desk review, key informant interviews (including questionnaire), and qualitative data collection, and analysis may be revised based on discussions with UNICEF, MOH and partners to be approved by the appropriate forums within MOH (Technical Working Groups/Steering Committee/expert focal points). Protocol development to be combined with research prioritization during a two days workshop. Once the IR protocol and tools are finalized and approved, the consultant will submit IP protocol and tools for ethical clearance from the local IRB. Tools and protocols for quantitative and qualitative data collection and analysis will have to be approved by appropriate forums within MOH, including review/feedback

Output 3: Data collection and analysis and preparation of IR reports with recommendations and project implementation improvement plan to be technically validated by RBC and the research team, and approved MoH. This help to ensure sustainable implementation of the Rwanda CRVS/Immunization Tracker and its replication elsewhere. After completion of data collection and analysis as per the design (output 1) a draft report consisting executive summary, background, methodology, findings, availability, affordability, approachability, appropriateness, acceptability, analysis & discussion, challenges, opportunities, and best practices; conclusions & recommendations with focus on how to improve implementation will be produced unless otherwise agreed between UNICEF and MOH in writing:

Output 4: Based on feedback from UNICEF, MOH and partners, approval/validation from the appropriate forums within MOH (Technical Working Groups, Steering Committee, experts programme focal points) a final report will be submitted. A Change Management Plan including the technical, human and organizational changes needed to ensure successful implementation of the immunization tracker and CVRS. Dissemination of research findings through a multi-stakeholders workshop and/or publication. The contracted consultant shall collaborate with MoH, UNICEF and partners to develop IR tools, research protocol and reports of desirable quality including;

• Integrated immunization track implementation improvement plan
• SOPs to guide and strengthen use of integrated immunization tracker and over all visualization, triangulation, analysis plan and use of data from different HMISs platforms.
• A presentation for dissemination of the final research report, integrated immunization tracker improvement plan and SOPs on data triangulation, analysis and use for real-time decisions

The write up of all outputs above should be in clear language so that they can be easily understood, avoiding long sentences, jargon, abbreviations and technical terms to the extent possible, and should as necessary define the terms used. As appropriate, the outputs must also contain tables, charts, diagrams or other visual materials to illustrate.

Deliverables, Timeframe, Payment Schedule

• An Inception Report demonstrating the understanding of the assignment and including the methodology and plan to successfully complete the implementation research,  5 days ,  10%
• Implementation research protocol and tools based on priority question,  15 days , 20%
• Draft report of the implementation research,  20 days , 30%
• Final report approved by appropriate forums within MOH, after validation and incorporating feedback, 20 days,  40%

Evaluation Criteria

The Technical proposal will be weighted at 70% and 30% for the Financial proposal.

Please note that the final remuneration will be negotiated by HR.

General Conditions: Procedures & Logistics

The recruited consultant will be required to have expertize for conducting the implementation research. In some circumstances, particular logistic arrangements shall be required to ensure time delivery of assigned tasks in quality deserved.

Therefore, in presenting proposals, bidders should take these elements into serious consideration that UNICEF will not be responsible for any unexpected additional cost or arrangement required during the implementation of the assignment.

UNICEF will hire one consultant for this assignment, and the hired consultant shall be responsible for hiring and paying own sub-contractors as will be necessary.

To qualify as an advocate for every child you will have…

The Consultant or Team of Consultants should have the following combined experience:

• IT System Analysis, wider knowledge and experience in RMNCAH and CRVS aprogramme areas
• Post-graduate training in Public Health, health statics/information systems, Sociology, Medical Anthropology, Psychology, Social Work or other related degree
• 8 years’ experience with a strong preference for professionals with experience in designing, implementing, analysis, evaluating, and documentation of MNCAH including immunization programmes
• Prior work experience with Government/or a multi-lateral or international health and development agency, and experience supporting RMNCAH/immunization programmes government in Rwanda/or region
• Language: English language is required, and know of French will be added value
• Strong ability to deliver on time

UNICEF’s values of Care, Respect, Integrity, Trust, and Accountability (CRITA) and core competencies in Communication, Working with People and Drive for Results.

How to Apply

UNICEF is committed to gender equality in its mandate and its staff. Well qualified candidates, particularly females are strongly encouraged to apply.

Interested candidates should send their complete Personal History (P11) form, which can be downloaded form (http://www.unicef.org/about/employ/files/P11.doc). or a CV/resume, as well as a cover letter explaining what makes them suitable for this consultancy. The application package should be submitted to UNICEF’s online recruitment system.

Qualified and experienced candidates are requested to submit a letter of interest including a Technical Proposal outlining a road map for review and implementation timeline. In their letter of interest, candidates should highlight their previous work experience relevant to the assignment, the attributes that make them suitable, their proposed approach to the assignment.

Only successful candidates from the technical evaluation exercise will be contacted and requested to submit their most competitive Financial Proposal.

UNICEF is committed to diversity and inclusion within its workforce, and encourages all candidates, irrespective of gender, nationality, religious and ethnic backgrounds, including persons living with disabilities, to apply to become a part of the organization.

UNICEF has a zero-tolerance policy on conduct that is incompatible with the aims and objectives of the United Nations and UNICEF, including sexual exploitation and abuse, sexual harassment, abuse of authority and discrimination. UNICEF also adheres to strict child safeguarding principles. All selected candidates will be expected to adhere to these standards and principles and will therefore undergo rigorous reference and background checks. Background checks will include the verification of academic credential(s) and employment history. Selected candidates may be required to provide additional information to conduct a background check.

Remarks:

Only shortlisted candidates will be contacted and advance to the next stage of the selection process.

Individuals engaged under a consultancy or individual contract will not be considered “staff members” under the Staff Regulations and Rules of the United Nations and UNICEF’s policies and procedures, and will not be entitled to benefits provided therein (such as leave entitlements and medical insurance coverage). Their conditions of service will be governed by their contract and the General Conditions of Contracts for the Services of Consultants and Individual Contractors. Consultants and individual contractors are responsible for determining their tax liabilities and for the payment of any taxes and/or duties, in accordance with local or other applicable laws.